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Navarro‐Miró D, Blanco‐Moreno JM, Ciaccia C, Testani E, Iocola I, Depalo L, Burgio G, Kristensen H, Hefner M, Tamm K, Bender I, Persiani A, Diacono M, Montemurro F, Willekens K, Védie H, Bavec M, Robačer M, Arlotti D, Deltour P, De Neve S, Gebremikael MT, Chamorro L, Caballero‐López B, Pérez‐Ferrer A, Canali S, Sans FX. The concurrent assessment of agronomic, ecological and environmental variables enables better choice of agroecological service crop termination management. J Appl Ecol 2022. [DOI: 10.1111/1365-2664.14112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- David Navarro‐Miró
- Agroecosystems Research Group, Biodiversity Research Institute (IRBio), and Section of Botany and Mycology, Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology University of Barcelona Barcelona Spain
| | - José M. Blanco‐Moreno
- Agroecosystems Research Group, Biodiversity Research Institute (IRBio), and Section of Botany and Mycology, Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology University of Barcelona Barcelona Spain
| | - Corrado Ciaccia
- Council for Agricultural Research and Economics Research Centre for Agriculture and Environment (CREA‐AA) Rome Italy
| | - Elena Testani
- Council for Agricultural Research and Economics Research Centre for Agriculture and Environment (CREA‐AA) Rome Italy
| | - Ileana Iocola
- Council for Agricultural Research and Economics Research Centre for Agriculture and Environment (CREA‐AA) Rome Italy
| | - Laura Depalo
- Dipartimento di Scienze e Tecnologie Agro‐Alimentari (DISTAL) Alma Mater Studiorum Università di Bologna Bologna Italy
| | - Giovanni Burgio
- Dipartimento di Scienze e Tecnologie Agro‐Alimentari (DISTAL) Alma Mater Studiorum Università di Bologna Bologna Italy
| | | | - Margita Hefner
- Department of Food Science Aarhus University Aarhus N Denmark
| | - Kalvi Tamm
- Department of Agrotechnology Estonian Crop Research Institute Jõgeva Estonia
| | - Ingrid Bender
- Department of Jõgeva Plant Breeding Estonian Crop Research Institute Jõgeva Estonia
| | - Alessandro Persiani
- Council for Agricultural Research and Economics Research Centre for Agriculture and Environment (CREA‐AA) Bari Italy
| | - Mariangela Diacono
- Council for Agricultural Research and Economics Research Centre for Agriculture and Environment (CREA‐AA) Bari Italy
| | - Francesco Montemurro
- Council for Agricultural Research and Economics Research Centre for Vegetable and Ornamental Crops (CREA‐OF) Monsapolo del Tronto Italy
| | - Koen Willekens
- Plant Sciences Unit Research Institute for Agriculture, Fisheries and Food Merelbeke Belgium
| | - Hélène Védie
- Research Group in Organic Agriculture Maison de la Bio Avignon France
| | - Martina Bavec
- Faculty of Agriculture and Life Sciences, Institute of Organic Agriculture University of Maribor Hoče Slovenia
| | - Martina Robačer
- Faculty of Agriculture and Life Sciences, Institute of Organic Agriculture University of Maribor Hoče Slovenia
| | - Donatienne Arlotti
- Soil fertility and Water Protection Unit, Agriculture and Natural environment Department Walloon Agricultural Research Center (CRA‐W) Gembloux Belgium
| | | | - Stefaan De Neve
- Soil Fertility and Nutrient Management Research Group, Department of Environment Ghent University Ghent Belgium
| | - Mesfin Tsegaye Gebremikael
- Soil Fertility and Nutrient Management Research Group, Department of Environment Ghent University Ghent Belgium
| | - Lourdes Chamorro
- Agroecosystems Research Group, Biodiversity Research Institute (IRBio), and Section of Botany and Mycology, Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology University of Barcelona Barcelona Spain
| | | | - Alejandro Pérez‐Ferrer
- Agroecosystems Research Group, Biodiversity Research Institute (IRBio), and Section of Botany and Mycology, Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology University of Barcelona Barcelona Spain
| | - Stefano Canali
- Council for Agricultural Research and Economics Research Centre for Agriculture and Environment (CREA‐AA) Rome Italy
| | - Francesc Xavier Sans
- Agroecosystems Research Group, Biodiversity Research Institute (IRBio), and Section of Botany and Mycology, Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology University of Barcelona Barcelona Spain
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Hernanz I, Miguel Escuder L, Chamorro L, Moll-Udina A, Espinosa G, Sainz de la Maza M, Llorenç V, Adán A. Tuberculosis-Related Uveitis in Patients under Anti-TNF-alpha Therapy: A Case Series. Ocul Immunol Inflamm 2020; 30:839-844. [PMID: 33216652 DOI: 10.1080/09273948.2020.1834588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Tumor necrosis factor inhibitors (anti-TNF) have emerged as an effective treatment in noninfectious uveitis (NIU). Anti-TNF may increase the predisposition to infectious disease as tuberculosis (TB). TB-related uveitis in the context of an uveitogenic concurrent systemic immune-mediated disease under anti-TNF treatment remain a diagnostic challenge, deserving special focus on this rare context. Retrospective chart review of patients on anti-TNF drugs for systemic immune-mediated diseases that developed a multicentric microbiologically confirmed active TB with concurrent intraocular involvement.Three patients were recorded. Screening for TB before starting anti-TNF resulted negative in two patients. The other patient had received anti-tuberculous treatment in the past. All showed a microbiologically confirmed extraocular TB after unexpected atypical reactivation of the uveitis shifting to chronic granulomatous pattern.Specialists should be aware of TB reactivation, even with previous negative screening, when ocular uveitis signs and activity do not match with the expected pattern in a patient on anti-TNF drugs.
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Affiliation(s)
- I Hernanz
- Hospital Clinic of Barcelona, Clínic Institute of Ophthalmology, University of Barcelona, Barcelona, Spain
| | - L Miguel Escuder
- Hospital Clinic of Barcelona, Clínic Institute of Ophthalmology, University of Barcelona, Barcelona, Spain
| | - L Chamorro
- Hospital Clinic of Barcelona, Clínic Institute of Ophthalmology, University of Barcelona, Barcelona, Spain
| | - A Moll-Udina
- Hospital Clinic of Barcelona, Clínic Institute of Ophthalmology, University of Barcelona, Barcelona, Spain.,Biomedical Research Institute August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - G Espinosa
- Hospital Clinic of Barcelona, Clínic Institute of Ophthalmology, University of Barcelona, Barcelona, Spain.,Biomedical Research Institute August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - M Sainz de la Maza
- Hospital Clinic of Barcelona, Clínic Institute of Ophthalmology, University of Barcelona, Barcelona, Spain.,Biomedical Research Institute August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - V Llorenç
- Hospital Clinic of Barcelona, Clínic Institute of Ophthalmology, University of Barcelona, Barcelona, Spain.,Biomedical Research Institute August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - A Adán
- Hospital Clinic of Barcelona, Clínic Institute of Ophthalmology, University of Barcelona, Barcelona, Spain.,Biomedical Research Institute August Pi I Sunyer (IDIBAPS), Barcelona, Spain
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Chamorro L, Lopez I. Treatment of the attention deficit disorder (residual type) with moclobemide. Eur Psychiatry 2020; 10:112. [DOI: 10.1016/0924-9338(96)80324-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/1994] [Accepted: 05/03/1994] [Indexed: 11/17/2022] Open
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Chamorro L. British Coleoptera larvae – A guide to the families and major subfamilies. Handbooks for the identification of British insects Vol. 4 Part 1a. J NAT HIST 2020. [DOI: 10.1080/00222933.2020.1714769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Lourdes Chamorro
- Systematic Entomology Laboratory, ARS, USDA, Washington, DC, USA,
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Huestis DL, Dao A, Diallo M, Sanogo ZL, Samake D, Yaro AS, Ousman Y, Linton YM, Krishna A, Veru L, Krajacich BJ, Faiman R, Florio J, Chapman JW, Reynolds DR, Weetman D, Mitchell R, Donnelly MJ, Talamas E, Chamorro L, Strobach E, Lehmann T. Windborne long-distance migration of malaria mosquitoes in the Sahel. Nature 2019; 574:404-408. [PMID: 31578527 DOI: 10.1038/s41586-019-1622-4] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 09/06/2019] [Indexed: 11/09/2022]
Abstract
Over the past two decades efforts to control malaria have halved the number of cases globally, yet burdens remain high in much of Africa and the elimination of malaria has not been achieved even in areas where extreme reductions have been sustained, such as South Africa1,2. Studies seeking to understand the paradoxical persistence of malaria in areas in which surface water is absent for 3-8 months of the year have suggested that some species of Anopheles mosquito use long-distance migration3. Here we confirm this hypothesis through aerial sampling of mosquitoes at 40-290 m above ground level and provide-to our knowledge-the first evidence of windborne migration of African malaria vectors, and consequently of the pathogens that they transmit. Ten species, including the primary malaria vector Anopheles coluzzii, were identified among 235 anopheline mosquitoes that were captured during 617 nocturnal aerial collections in the Sahel of Mali. Notably, females accounted for more than 80% of all of the mosquitoes that we collected. Of these, 90% had taken a blood meal before their migration, which implies that pathogens are probably transported over long distances by migrating females. The likelihood of capturing Anopheles species increased with altitude (the height of the sampling panel above ground level) and during the wet seasons, but variation between years and localities was minimal. Simulated trajectories of mosquito flights indicated that there would be mean nightly displacements of up to 300 km for 9-h flight durations. Annually, the estimated numbers of mosquitoes at altitude that cross a 100-km line perpendicular to the prevailing wind direction included 81,000 Anopheles gambiae sensu stricto, 6 million A. coluzzii and 44 million Anopheles squamosus. These results provide compelling evidence that millions of malaria vectors that have previously fed on blood frequently migrate over hundreds of kilometres, and thus almost certainly spread malaria over these distances. The successful elimination of malaria may therefore depend on whether the sources of migrant vectors can be identified and controlled.
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Affiliation(s)
- Diana L Huestis
- Laboratory of Malaria and Vector Research, NIAID, NIH, Rockville, MD, USA
| | - Adama Dao
- Malaria Research and Training Center (MRTC), Faculty of Medicine, Pharmacy and Odonto-stomatology, University of Bamako, Bamako, Mali
| | - Moussa Diallo
- Malaria Research and Training Center (MRTC), Faculty of Medicine, Pharmacy and Odonto-stomatology, University of Bamako, Bamako, Mali
| | - Zana L Sanogo
- Malaria Research and Training Center (MRTC), Faculty of Medicine, Pharmacy and Odonto-stomatology, University of Bamako, Bamako, Mali
| | - Djibril Samake
- Malaria Research and Training Center (MRTC), Faculty of Medicine, Pharmacy and Odonto-stomatology, University of Bamako, Bamako, Mali
| | - Alpha S Yaro
- Malaria Research and Training Center (MRTC), Faculty of Medicine, Pharmacy and Odonto-stomatology, University of Bamako, Bamako, Mali.,Faculte des Sciences et Techniques, Universite des Sciences des Techniques et des Technologies de Bamako (FSTUSTTB), Bamako, Mali
| | - Yossi Ousman
- Malaria Research and Training Center (MRTC), Faculty of Medicine, Pharmacy and Odonto-stomatology, University of Bamako, Bamako, Mali
| | - Yvonne-Marie Linton
- Walter Reed Biosystematics Unit, Smithsonian Institution Museum Support Center, Suitland, MD, USA.,Department of Entomology, Smithsonian Institution, National Museum of Natural History, Washington, DC, USA
| | - Asha Krishna
- Laboratory of Malaria and Vector Research, NIAID, NIH, Rockville, MD, USA
| | - Laura Veru
- Laboratory of Malaria and Vector Research, NIAID, NIH, Rockville, MD, USA
| | | | - Roy Faiman
- Laboratory of Malaria and Vector Research, NIAID, NIH, Rockville, MD, USA
| | - Jenna Florio
- Laboratory of Malaria and Vector Research, NIAID, NIH, Rockville, MD, USA
| | - Jason W Chapman
- Centre for Ecology and Conservation, University of Exeter, Penryn, UK.,College of Plant Protection, Nanjing Agricultural University, Nanjing, China.,Environment and Sustainability Institute, University of Exeter, Penryn, UK
| | - Don R Reynolds
- Natural Resources Institute, University of Greenwich, Chatham, UK.,Rothamsted Research, Harpenden, UK
| | - David Weetman
- Department of Vector Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Reed Mitchell
- Walter Reed Biosystematics Unit, Smithsonian Institution Museum Support Center, Suitland, MD, USA
| | - Martin J Donnelly
- Department of Vector Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Elijah Talamas
- Systematic Entomology Laboratory - ARS, USDA, Smithsonian Institution National Museum of Natural History, Washington, DC, USA.,Florida Department of Agriculture and Consumer Services, Department of Plant Industry, Gainesville, FL, USA
| | - Lourdes Chamorro
- Department of Entomology, Smithsonian Institution, National Museum of Natural History, Washington, DC, USA.,Systematic Entomology Laboratory - ARS, USDA, Smithsonian Institution National Museum of Natural History, Washington, DC, USA
| | - Ehud Strobach
- Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD, USA.,Global Modeling and Assimilation Office, NASA GSFC, Greenbelt, MD, USA
| | - Tovi Lehmann
- Laboratory of Malaria and Vector Research, NIAID, NIH, Rockville, MD, USA.
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Chamorro L, Jendek E. Six new species of Agrilus Curtis, 1825 (Coleoptera, Buprestidae, Agrilinae) from the Oriental Region related to the emerald ash borer, A. planipennis Fairmaire, 1888 and synonymy of Sarawakita Obenberger, 1924. Zookeys 2012:71-94. [PMID: 23226712 PMCID: PMC3497257 DOI: 10.3897/zookeys.239.3966] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Accepted: 11/02/2012] [Indexed: 11/15/2022] Open
Abstract
Six new species of Agrilus Curtis, 1825 with affinities to the emerald ash borer, Agrilus planipennis Fairmaire, 1888, are described from the Oriental Region: Agrilus crepuscularissp. n. (Malaysia); Agrilus pseudolubopetrisp. n. (Laos); Agrilus sapphirinussp. n.(Laos); Agrilus seramensissp. n.(Indonesia); Agrilus spineussp. n. (Malaysia); and Agrilus tomentipennissp. n. (Laos). The genus Sarawakita Obenberger, 1924 syn. nov. is considered a junior synonym of Agrilus.
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Chamorro L, de Felipe MV, Soler MM, Olivares D, Huertas D. Intellectual capacity measurement in schizophrenia. Actas Esp Psiquiatr 2008; 36:33-38. [PMID: 18286398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
INTRODUCTION The measurement of the intellectual capacity (IC) in schizophrenic patients has been found to be of clinical relevance. A user-friendly tool such as the Cattell's intelligence test might facilitate this measurement in daily clinical practice. METHOD In this study, we measured the intelligence quotient (IQ) using Cattell's test in 35 schizophrenic patients before and after treatment with risperidone. RESULTS At baseline, the sample showed an average intelligence of 78.3 points (standard deviation [SD]: 14.3), in the low-medium range. After 1 year on risperidone, the IQ significantly improved (mean: 84.8; SD: 17.0; p = 0.028). This IQ elevation was positively correlated with the improvement in the psychotic symptoms rated with the PANSS. CONCLUSIONS Cattell's intelligence test could be a valid instrument to measure cognitive performance in schizophrenic patients. Antipsychotic therapy with risperidone could be effective to improve cognitive functioning in these subjects.
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Affiliation(s)
- L Chamorro
- Psychiatry Department, Universidad de Alcalá, Madrid, Spain.
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Vieta E, Sánchez-Moreno J, Bulbena A, Chamorro L, Ramos JL, Artal J, Pérez F, Oliveras MA, Valle J, Lahuerta J, Angst J. Cross validation with the mood disorder questionnaire (MDQ) of an instrument for the detection of hypomania in Spanish: the 32 item hypomania symptom check list (HCL-32). J Affect Disord 2007; 101:43-55. [PMID: 17189651 DOI: 10.1016/j.jad.2006.09.040] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2006] [Accepted: 09/06/2006] [Indexed: 10/23/2022]
Abstract
BACKGROUND The detection and diagnosis of present or past hypomanic episodes is of key importance for the differential diagnosis between depressive disorders and type II bipolar disorder. However, there are few instruments available to satisfactorily screen for the latter condition. The Hypomania Symptom Checklist-32 (HCL-32) is a self-applied questionnaire with 32 hypomania items and 8 severity and functional impact items which is being developed in several European countries for this purpose. Our aim was to develop and validate the psychometric properties of the HCL-32 scale in Spain in patients with bipolar disorder and to compare its properties with other instruments available for the detection of bipolar II disorder. METHODS Patients were selected from 15 psychiatric outpatient departments, diagnosed with type I or type II bipolar disorder (BDI and BDII) and unipolar major depression (MD) according to DSM-IV-TR criteria. A control group of healthy subjects (HS) was likewise assessed. The patient selection criteria included a well-established diagnosis and a stable disorder and pharmacological treatment. The HCL-32 was administered to 237 subjects distributed among the above groups, on two occasions four weeks apart. We analysed the internal consistency, test-retest reliability and discriminative capacity of the HCL-32. RESULTS The internal consistency of the Spanish version of the HCL-32, evaluated by Cronbach's alpha, was 0.94. Mean of affirmative questions by group were 21.2 (SD 5.8) for BDI, 19.3 (SD 6.2) for BDII, 8.6 (SD 6.6) for MD and 6.6 (SD 6.1) for HS, with statistically significant differences between them (Kruskal-Wallis test, p<0.001). Concurrent validity using the diagnosis variable was 0.72. Test-retest reliability was 0.90. We analysed the best cut-off point by means of a ROC curve analysis; for 14 affirmative responses, a sensitivity of 0.85 95%CI (0.78, 0.91) and specificity of 0.79, 95%CI (0.72, 0.87) were obtained. The positive and negative probability ratios were 4.1 and 5.3 (1/0.19 respectively). HCL-32 shows a dual factor structure of items, one as an energy-activity factor and another one as a factor involving items related to disinhibition and problems with self-control and attention. LIMITATIONS The sample size of bipolar patients (particularly type BDII) should be increased in further studies. CONCLUSIONS The Spanish version of the HCL-32 has good psychometric properties and sufficient sensitivity and specificity, detecting 8 out of every 10 patients with BD. The HCL-32 is a useful screening tool of patients with bipolar disorder in clinical settings. In its present form it adequately discriminates between bipolar and unipolar or healthy subjects, but not between BD I and BII.
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Affiliation(s)
- E Vieta
- Bipolar Disorder Programme, Institut Clínic de Neurociencies, Hospital Clinic, IDIBAPS, Universitat de Barcelona, Barcelona Stanley Foundation Centrem, Villarroel, 170, 08036 Barcelona, Spain.
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Arango C, Gómez-Beneyto M, Brenlla J, Gastó C, Sarramea-Crespo F, Chamorro L, Masramon X, Díez T. A 6-month prospective, observational, naturalistic, uncontrolled study to evaluate the effectiveness and tolerability of oral ziprasidone in patients with schizophrenia. Eur Neuropsychopharmacol 2007; 17:456-63. [PMID: 17234389 DOI: 10.1016/j.euroneuro.2006.11.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2006] [Revised: 11/21/2006] [Accepted: 11/29/2006] [Indexed: 01/28/2023]
Abstract
This multicenter, uncontrolled, naturalistic study evaluated the effectiveness and tolerability of 6 months of treatment with ziprasidone in 1266 patients with a diagnosis of schizophrenia. The percentage of responders (at least 30% reduction in PANSS total score) in the primary analysis sample (n=1022) was 47.3% (95% CI 44.2-50.4) at the end of the study. Patients showed a significant and clinically relevant reduction in the PANSS total, positive, negative and general psychopathology subscales scores (effect size of 1.60, 1.83, 0.62 and 1.40 respectively). Overall, 453 (35.8%) patients withdrew from the study; 9.3% withdrew owing to adverse events. Ziprasidone doses greater than 120 mg/day were associated with a lower risk of discontinuation for any cause (OR 0.46, 95% CI 0.33-0.65) Ziprasidone was well tolerated. Most common side effects were: insomnia, somnolence and nervousness. The effectiveness and tolerability of ziprasidone in clinical practice are consistent to those previously shown in the more restricted and homogeneous populations of clinical trials.
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Affiliation(s)
- C Arango
- Hospital General Universitario Gregorio Marañón, Madrid, Spain.
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Polo R, José Galindo M, Martínez E, Alvarez J, Arévalo JM, Asensi V, Cánoves D, Cáncer E, Collazos J, Estrada V, Gómez-Candela C, Johnston S, Locutura J, López-Aldeguer J, Lozano F, Miralles C, Muñoz-Sanz A, Ortega E, Pascua J, Pedrol E, Pulido F, San Martín M, Sanz J, Viciana P, Chamorro L. Recomendaciones de GEAM/SPNS sobre el tratamiento de las alteraciones metabólicas y morfológicas en el paciente con infección por VIH. Enferm Infecc Microbiol Clin 2006; 24:96-117. [PMID: 16545318 DOI: 10.1157/13085017] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To provide an update of the metabolic and morphologic alterations in patients infected with HIV with an in-depth analysis of their clinical management and treatment. METHODS These recommendations were agreed by consensus by a committee of experts in metabolic alterations and HIV patient care, under the auspices of the Secretariat for the National AIDS Plan. To do this, the latest clinical, epidemiological and physiopathological advances described in studies published in the scientific literature and/or presented in congresses were reviewed. RESULTS The most frequent metabolic alterations in HIV patients and in antiretroviral treatment (ART) are dyslipidemia with an atherogenic profile and alterations in carbohydrate metabolism/insulin resistance. A high prevalence of cardiovascular risk factors, especially smoking, has been described. The same criteria for their management as those used in the general population have been employed, with specific nuances. Diet and exercise should be the first therapeutic recommendation. In patients with dyslipidemia who require drug treatment, statins and/or fibrates are indicated. Glitazones have demonstrated efficacy in the treatment of insulin resistance. The approach to anomalous fat distribution continues to be controversial. The main approaches at present are a switch of ART, reparative surgery, psychological support and lifestyle changes. Lactic acidosis is an infrequent but highly serious complication, and the first step is withdrawal of ART. In bone metabolism alterations, prevention and early detection are essential, especially in children and perimenopausal women. Sexual dysfunction is a frequent problem in both men and women; because the causes are highly varied, treatment should be individualized. CONCLUSIONS The prevalence of metabolic and morphologic alterations has increased since the introduction of highly active antiretroviral treatment (HAART). Knowledge of the various aspects involved in their diagnosis and treatment is essential for the appropriate care of patients with HIV infection.
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Affiliation(s)
- Rosa Polo
- Consejera Técnica, Plan Nacional sobre el Sida, Madrid, España.
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Miró JM, Torre-Cisnero J, Moreno A, Tuset M, Quereda C, Laguno M, Vidal E, Rivero A, Gonzalez J, Lumbreras C, Iribarren JA, Fortún J, Rimola A, Rafecas A, Barril G, Crespo M, Colom J, Vilardell J, Salvador JA, Polo R, Garrido G, Chamorro L, Miranda B. [GESIDA/GESITRA-SEIMC, PNS and ONT consensus document on solid organ transplant (SOT) in HIV-infected patients in Spain (March, 2005)]. Enferm Infecc Microbiol Clin 2005; 23:353-62. [PMID: 15970168 DOI: 10.1157/13076175] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Solid organ transplant may be the only therapeutic alternative in some HIV-infected patients. Experience in North America and Europe during the last five years shows that survival at three years after an organ transplant is similar to that observed in HIV-negative patients. The criteria agreed upon to select HIV patients for transplant are: no opportunistic infections (except tuberculosis, oesophageal candidiasis or P. jiroveci -previously carinii- pneumonia), CD4 lymphocyte count above 200 cells/.L (100 cells/.L in the case of liver transplant) and an HIV viral load which is undetectable or suppressible with antiretroviral therapy. Another criterion is a two-year abstinence from heroin and cocaine, although the patient may be in a methadone programme. The main problems in the post-transplant period are pharmacokinetic and pharmacodynamic interactions between antiretorivirals and immunosuppressors, rejection and the management of relapse of HCV infection, which is one of the main causes of post-liver transplant mortality. Up to now, experience with pegylated interferon and ribavirin is scarce in this population. The English version of the manuscript is available at http://www.gesidaseimc.com.
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Affiliation(s)
- José M Miró
- AIDS Study Group (GESIDA) of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC).
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Ramos JT, de José MI, Polo R, Fortuny C, Mellado MJ, Muñoz-Fernández MA, Beceiro J, Bertrán JM, Calvo C, Chamorro L, Ciria L, Guillén S, González-Montero R, González-Tomé MI, Gurbindo MD, Martín-Fontelos P, Martínez-Pérez J, Moreno D, Muñoz-Almagro MC, Mur A, Navarro ML, Otero C, Rojo P, Rubio B, Saavedra J. Recomendaciones CEVIHP/SEIP/AEP/PNS respecto al tratamiento antirretroviral en niños y adolescentes infectados por el VIH. Enferm Infecc Microbiol Clin 2005; 23:279-312. [PMID: 15899180 DOI: 10.1157/13074970] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To update antiretroviral recommendations in antiretroviral therapy (ART) in HIV-infected children and adolescents. METHODS Theses guidelines have been formulated by a panel of members of the Plan Nacional sobre el SIDA (PNS) and the Asociacion Espanola de Pediatria (AEP) by reviewing the current available evidence of efficacy, safety, and pharmacokinetics in pediatric studies. Three levels of evidence have been defined according to the source of data: Level A: randomized and controlled studies; Level B: Cohort and case-control studies; Level C: Descriptive studies and experts' opinion. RESULTS When to start ART should be made on an individual basis, discussed with the family, considering the risk of progression according to age, CD4 and viral load, the ART-related complications and adherence. The ART goal is to reach a maximum and durable viral suppression. This is not always possible, even with clinical and immunologic improvement. The difficulties of permanent adherence and side-effects are resulting in a more conservative trend to initiate ART, and to less toxic and simpler strategies. Currently, combinations of at least three drugs are of first choice both in acute and chronic infection. They must include 2 NA 1 1 NN or 2 NA 1 1 PI. ART is recommended in all symptomatic patients and, with few exceptions, in all infants in the first year of life. Older asymptomatic children should start ART according to CD4 count, especially CD4 percentage, that vary with age. Despite potent salvage therapies, it is common not to reach viral undetectability. Therapeutical options when ART fails are scarce due to cross-resistance. The cause of failure must be identified. Occasionally, there exists clinical and/or immunological progression, and a change of therapy with at least two new drugs still active for the patient, is warranted with the aim of increasing the CD4 count to a lower level of risk. Toxicity and adherence must be regularly monitored. Some aspects about post exposure prophylaxis and coinfection with HCV or HBV are discussed. CONCLUSIONS A higher level of evidence with regard to ART effectiveness and toxicity in pediatrics is currently available, leading to a more conservative and individualized approach. Clinical symptoms and CD4 count are the main determinants to start and change ART.
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Affiliation(s)
- José Tomás Ramos
- Unidad de Inmunodeficiencias, Departamento de Pediatría, Hospital 12 Octubre, 28041 Madrid, Spain.
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Knobel H, Escobar I, Polo R, Ortega L, Martín-Conde MT, Casado JL, Codina C, Fernández J, Galindo MJ, Ibarra O, Llinas M, Miralles C, Riera M, Fumaz CR, Segador A, Segura F, Chamorro L. Recomendaciones GESIDA/SEFH/PNS para mejorar la adherencia al tratamiento antirretroviral en el año 2004. Enferm Infecc Microbiol Clin 2005; 23:221-31. [PMID: 15826548 DOI: 10.1157/13073149] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Since the early days of antiretroviral therapy, adherence has emerged as the milestone of success; in fact, it is the most potent predictor of effectiveness. The main factors related to adherence include the complexity of the therapeutic regimen, adverse effects, psychological problems, alcoholism and active addiction to drugs, lack of social and family support and the patient's beliefs and attitudes about the treatment. Adherence monitoring should be part of the HIV patient's regular care, and should be done with feasible, easily applied methods adapted to the different clinical settings. The minimally acceptable measures should include use of a validated questionnaire, together with data from the Pharmacy Department's drug dispensation registry. All patients that begin HAART or undergo a change of treatment should participate in a treatment education program imparted by health professionals with knowledge and experience in the management of patients with HIV infection. The health team (doctors, pharmacists and nursing professionals) should offer maximum availability to solve the doubts and problems that may occur during treatment. When sub-optimal adherence is detected, intervention strategies based on psychological therapy, educational efforts and personal advice should be attempted, in order to adapt the treatment scheme to the patient's habits and provide solutions to the problem of non-compliance. In certain situations, co-morbid conditions will also require attention. Treatment adherence, being a multidimensional problem, needs a multidisciplinary team approach. The choice of therapy, only one aspect of the multidimensional problem of adherence, must be a careful and individualized decision; however, simpler regimens with regard to the number of pills and daily dose are desirable.
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Affiliation(s)
- Hernando Knobel
- Servicio Medicina Interna, Hospital del Mar, Barcelona, Spain.
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Iribarren JA, Labarga P, Rubio R, Berenguer J, Miró JM, Antela A, González J, Moreno S, Arrizabalaga J, Chamorro L, Clotet B, Gatell JM, López-Aldeguer J, Martínez E, Polo R, Tuset M, Viciana P, Santamaría JM, Kindelán JM, Ribera E, Segura F. Recomendaciones de GESIDA/Plan Nacional sobre el Sida respecto al tratamiento antirretroviral en pacientes adultos infectados por el VIH (octubre 2004). Enferm Infecc Microbiol Clin 2004; 22:564-642. [PMID: 15596051 DOI: 10.1157/13069520] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE This consensus document is an update of antiretroviral therapy (ART) recommendations for adult patients infected with the human immunodeficiency virus (HIV). METHODS To formulate these recommendations, a panel composed of members of the Grupo de Estudio de Sida (GESIDA; AIDS Study Group) and the Plan Nacional sobre el Sida (PNS; Spanish AIDS Plan) reviewed the advances in current understanding of the pathophysiology of HIV, the safety and efficacy findings from clinical trials, and the results from cohort and pharmacokinetic studies published in biomedical journals or presented at scientific meetings over the last years. Three levels of evidence were defined according to the source of the data: randomized studies (level A), cohort or case-control studies (level B), and expert opinion (level C). The decision to recommend, consider or not recommend ART was established in each of these situations. RESULTS ART consisting of at least three drugs is currently the initial treatment of choice for chronic HIV infection. These regimens should include 2 NRTI + 1 NNRTI or 2 NRTI + 1 PI. Initiation of ART is recommended in patients with symptomatic HIV infection. In asymptomatic patients, initiation of ART is recommended on the basis of CD4+ lymphocyte counts per L and plasma viral load, as follows: 1) Therapy should be started in patients with CD4+ counts of < 200 cells/microL; 2) Therapy should be started in most patients with CD4+ counts of 200-350 cells/microL, although it can be delayed when CD4+ count persists at around 350 cells/microL and viral load is low; and 3) Initiation of therapy can be delayed in patients with CD4+ counts of > 350 cells/microL. The initial objective of ART is to achieve an undetectable viral load. Adherence to therapy plays an essential role in maintaining the antiviral response. Because of the development of cross resistance, therapeutic options are limited when ART fails. Genotype studies are useful in these cases. Toxicity is a limiting factor in the use of ART, although the benefits outweigh the risks. In addition, the criteria for the use of ART are discussed in situations of acute infection, pregnancy, and post-exposure prophylaxis, and in the management of co-infection of HIV with HCV or HBV. CONCLUSIONS CD4+ lymphocyte count is the most important reference factor for initiating ART in asymptomatic patients. The large number of available drugs, the increased sensitivity of tests to monitor viral load, and the possibility to determine viral resistance is leading to a more individualized approach to therapy.
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Escobar I, Knobel H, Polo R, Ortega L, Martín-Conde MT, Casado JL, Codina C, Fernández J, Galindo MJ, Ibarra O, Llinas M, Miralles C, Riera M, Fumaz CR, Segador A, Segura F, Chamorro L. [GESIDA/SEFH/PNS recommendations to improve adherence to antiretroviral therapy in 2004]. Farm Hosp 2004; 28:6-18. [PMID: 15649111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023] Open
Affiliation(s)
- I Escobar
- Servicio de Farmacia, Hospital Universitario Doce de Octubre, 28041 Madrid.
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Herruzo R, Chamorro L, García ME, González MC, López AM, Manceñido N, Yébenes L. Prevalence and antimicrobial-resistance of S. pneumoniae and S. pyogenes in healthy children in the region of Madrid. Int J Pediatr Otorhinolaryngol 2002; 65:117-23. [PMID: 12176181 DOI: 10.1016/s0165-5876(02)00145-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
UNLABELLED Streptococcus pneumoniae and Streptococcus pyogenes are common agents of respiratory or ORL pathology. Pneumococcus sensitivity has progressively decreased to penicillin and other antimicrobial agents, mainly in south of Europe, but this resistance report can be erroneous by a selection bias, because they sampled only hospital cases. OBJECTIVES To determine the prevalence, antimicrobial susceptibility and risk factors of S. pneumoniae and S. pyogenes in healthy children under 5 years of age who go to infant school. SUBJECT AND METHODS Cross sectional study in six infant schools. An epidemiological inquiry (risk factors of carrier state) was filled out and a nasopharyngeal specimen was taken from each child, S. pneumoniae and S. pyogenes were identified and antimicrobial tests were performed. RESULTS We have studied 156 children with a mean age of 2.24 (standard deviation (S.D.), 0.85) and 58% have been treated with antibiotic in the last 3 months. The prevalence of S. pneumoniae or S. pyogenes were 12.2 and 5.1%, respectively. S. pyogenes only was isolated in two schools. Age was associated with S. pyogenes carrier but the rest of studied factors have no statistical significance with both microorganisms. All the S. pneumoniae showed resistance to one or more antibiotic (mainly to clavunate-amoxycillin: 94.7%), while S. pyogenes only was resistant to clavunate-amoxycillin. CONCLUSION Healthy children (0-4 years) with antibiotherapy in last 3 months have a great frequency of resistant S. pneumoniae. It is necessary to reduce the antibiotic use at home (Medical education).
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Affiliation(s)
- R Herruzo
- Departamento de Medicina Preventiva, Universidad Autonoma de Madrid, C/Arzobispo Morcillo number 4, 28029 Madrid, Spain.
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Vicent MG, Madero L, Chamorro L, Madero R, Diaz MA. Comparative cost analysis of autologous peripheral blood progenitor cell and bone marrow transplantation in pediatric patients with malignancies. Haematologica 2001; 86:1087-94. [PMID: 11602415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023] Open
Abstract
BACKGROUND AND OBJECTIVES This study was conducted in order to compare and analyze clinical and economic outcomes of autologous transplantation using bone marrow or peripheral blood as the source of hematopoietic progenitor cells in pediatric patients with malignancies. DESIGN AND METHODS We collected clinical information and resource utilization from 131 consecutive autologous transplantations (102 peripheral blood progenitor cell (PBPC) and 29 bone marrow (BM) transplants) at a single institution between January 1989 and December 1998 in children with a variety of malignancies. Multivariable linear regression was used to evaluate the associations between pre-transplantation variables, post-infusion events and overall costs. A cost-effectiveness analysis of transplantation for acute lymphoblastic leukemia (ALL) and acute myeloblastic leukemia (AML) patients was also performed. RESULTS Hematopoietic recovery was faster in the PBPCT group (days to neutrophil and platelet engraftment: 9 and 13, respectively, versus 14 and 21 for BMT, p<0.0001). There were less transfusion, antibiotic and parenteral nutrition requirements and hospital stay was shorter (median 17 days; range 8-38) in the PBPCT group than in the BMT one (median 28 days; range 11-65) (p<0.0001) resulting in a median lower overall cost for PBPCT (US$ 7895) compared to BMT (US$ 11820)(p<0.0001). Major determinants of overall costs for both groups were total body irradiation (TBI)-based conditioning regimen, days of hospitalization and number of transfused platelets. In PBPCT patients, a graft containing > or = 5 x 10(6)/kg CD34+ cells decreased the total cost of transplantation by 27%. Cost-effectiveness was higher for PBPCT than BMT for pediatric AML patients (p<0.0001) whereas in ALL patients the cost-effectiveness of the two transplant strategies was not significantly different. INTERPRETATIONS AND CONCLUSIONS We conclude that, compared to BMT, autologous PBPCT in children is associated not only with clinical benefits but also economic advantages.
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Affiliation(s)
- M G Vicent
- Department of Pediatrics, Division of Pediatric Hematology/Oncology "Niño Jesus" Children's Hospital, Madrid, Spain
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Castel B, Chamorro L, Olivares D, Huertas D. [The use of electroconvulsive therapy in acute services at the general hospital]. Actas Esp Psiquiatr 2000; 28:88-95. [PMID: 10937389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
GOAL The aim of the investigation focused on a retrospective analysis of the clinical use of ECT in the Acute Psychiatric Unit of The University Hospital of Guadalajara. METHOD All patients admitted to our psychiatric unit from 1993 to 1998 and who underwent ECT along their hospitalization, were included in the analysis. Age of the sample ranged from 17 to 79. Several variables were controlled, including technical parameters of ETC application. RESULTS All patients with a diagnosis of bipolar disorder or schizoaffective disorder showed full remission after ECT. Among patients diagnosed of schizophrenia, 60% experimented full remission and 40% partial remission. In the group of subjects with depression, 66.6% showed full remission, 27.7% partial remission and 5.7% no response. Besides, ETC appeared to be more effective in subjects without psychiatric comorbidity. CONCLUSION The present retrospective analysis support that ECT still must be considered an effective, useful and safe therapeutic technique. In our review, adverse reactions to ECT have been limited and rare, and mostly reversible.
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Affiliation(s)
- B Castel
- Servicio de Psiquiatría, Hospital General Universitario de Guadalajara
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Huertas D, Bautista S, Sanjoaquín A, Chamorro L, Gilaberte I. [Subsyndromal depressive semiology in severe alcoholism]. Actas Esp Psiquiatr 1999; 27:223-7. [PMID: 10469942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
INTRODUCTION Several investigations have communicated frequent association between alcohol dependence and depression. METHOD 21 subjects with DSM-IV criteria for alcohol dependence were included in an open label trial for alcohol withdrawal. At inclusion and along the follow-up none of the probands met DSM-IV criteria for mood disorder. Follow-up included a 15-day detoxification period and 195 days of withdrawal program, including treatment with 20 mg/d of fluoxetine. Occurrence of depressive semiology was measured using the Beck Depression Inventory (BDI) on day 15 (after detoxification), day 75 and day 210 (after withdrawal from ethanol of 195 days). RESULTS 67% of the sample showed a positive basal BDI (after-detoxification-BDI> 9). Global retention rate after 210 days of follow-up was 57%. All patients who dropped out the investigation before completing the protocol showed a basal BDI in the depressive rank (BDI= 10-63), and maintained depressive scores in this instrument until their abandonment. CONCLUSIONS Prevalence of <<subsyndromal depressive semiology>> in this population appears to be high. This clinical feature is frequently ignored because most of the patients do not meet standardized diagnostic criteria for mood disorders. Post-detoxification BDI could be used as a predictive factor of therapeutic result in long-term alcohol withdrawal programs. In addition, in our study fluoxetine showed efficacy in maintaining long-term alcohol abstinence.
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Affiliation(s)
- D Huertas
- Servicio de Psiquiatría, Hospital Universitario de Guadalajara, Guadalajara, 19002, España
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Huertas D, Molina JD, Chamorro L, Toral J. [Delirium in delusions of negations of Cotard: syndrome versus disorder]. Actas Luso Esp Neurol Psiquiatr Cienc Afines 1997; 25:333-40. [PMID: 9547216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This article constitutes the first of a series directed to review fundamental disorders in clinical psychogeriatrics. This sort of publication is intended to retrieve clinical practice as the cornerstone for research and teaching in psychiatry. Besides, and particularly in geriatry, we try to expand the strategy of liaison work with primary physicians. In this case, a nosological review of the so called "delusion of negations" is presented. The Jules Cotard's original concept of subtype of delusional melancholia is contrasted to the view of numerous authors in this century who have described it as a form of non-specific delusional syndrome.
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Affiliation(s)
- D Huertas
- Servicio de Psiquiatría, Hospital Universitario de Guadalajara
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Affiliation(s)
- L Chamorro
- Departamento de Parasitología, Facultad de Farmacia, Universidad Complutense, Madrid, España
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Lozano M, Chamorro L, Ríos B, Fuentes P. [Study of opiate addicts admitted to a general hospital. Experience with the model of collaborative psychiatry]. Med Clin (Barc) 1985; 84:353-6. [PMID: 3990418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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